The present disclosure generally relates to surgical devices. In particular, a load distributor for a sternum closure device, a sternum closure device comprising the load distributor, a tool for cutting the load distributor, and a sternum closure system comprising the load distributor and the tool are described.
To promote the healing process of fragmented or cut bone, it has been known to exert an external force on bone parts by tightly clamping them together. To this end, flexible elongated members such as wires can be used which are tensioned around the bone parts.
For example, prior to heart surgery, the sternum bone is often cut into two halves by means of a longitudinal section to obtain access to the heart. The sternum halves later need to be fixedly joined again. This can be done by arranging a wire around the sternum halves in a circumferential manner so as to surround a cross-sectional area thereof. Said cross-sectional area extends typically transverse to the longitudinal section through the sternum. Afterwards, the wire is tensioned and fixed by connecting and twisting the free ends thereof.
Furthermore, it has been known to arrange protector pads between the wire and an adjacent surface of the respective bone fragments. The protector pads avoid that the wire cuts into the bone surface when tensioning it, thus causing damage to the bone.
U.S. Pat. No. 6,287,307 B1 discloses an apparatus and a method for clamping the split bone sections of a sternum. For doing so, protector pads in form of sternal plates are arranged in opposite configuration at the split sternum halves. The sternum plates are provided with spikes which are driven into outer side surfaces of the sternum halves by means of a forceps. The sternum plates are hence directly fixed at the bone fragments in a first step. Afterwards, a surgeon can guide and tension a circumferential wire around the sternum plates and the bone fragments arranged therebetween.
U.S. Pat. No. 8,597,327 B2 teaches a method and apparatus for securing a fractured or sectioned sternum by means of a flexible member construct forming circumferential loops around the sternum halves. In addition, protector members are provided for guiding and fixing said flexible member construct around the sternum halves.
WO 2012/027025 A2 discloses a method for closing a sternum with help of adhesives. The adhesives may also be applied in contact regions between the sternum halves and an additionally provided circumferential wire to form a protective layer similar to the known protector pads.
WO 2014/149244 A1 relates to protective sleeve. A guide wire is movable within the protective sleeve and comprises a stop, such that it can abut on the protective sleeve in order to advance the protective sleeve to a desired resting position. Once this resting position is reached, the guide wire is pulled from the protective sleeve.